Adrenocortical cancer: mortality, hormone secretion, proliferation and urine steroids – experience from a single centre spanning three decades

BMC Endocrine Disorders

Research Article

Freja Calissendorff¹  Jan Calissendorff²  Henrik Falhammar³ 

[1] Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden;Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden;Endocrine Section, VO Internmedicin, Södersjukhuset, Sjukhusbacken 10, 118 83, Stockholm, Sweden;Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden;

关键词: Adrenalectomy;    Ki-67;    Mortality;    Survival;    Adrenocortical carcinoma;    Prognosis;    Urinary steroid profile;   

DOI  :  10.1186/s12902-016-0095-9

 received in 2015-07-10, accepted in 2016-03-10,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAdrenocortical carcinoma (ACC) is a rare malignant disease with a poor prognosis. Our aims were to study survival and to explore prognostic markers.MethodsWe retrospectively investigated the medical records of all 50 ACC patients at a single centre diagnosed between 1985 and 2012 and followed them up until 31/12/2014.ResultsOf this cohort, twenty six (52 %) were females. Adrenalectomy was performed in 48 patients (96 %), and twenty seven (54 %) were treated with adjuvant cytotoxic agents. The tumor sizes ranged from 6 to 20 cm. Overall survival time was 5.5 years (0.3–19.8), the two and five-year survival was 64 and 40 %, respectively. In ENSAT stage II 25/48 patients had a median survival of 7.0 years (0.7–15.5), in stage III 8/48 this was 1.9 (0.4 – 19.8), and in stage IV 15/48 it was 1.2 (0.3–3.6) years. Seventeen patients (34 %) were still alive at the end of 2014. The total follow-up time was 8.4 (0.3–19.8) years. Cell proliferation measured with Ki-67 had a median value of 15 % (2–80) and the urinary steroid profile was clearly pathologic in 29 of 43 (67 %) tested patients. The proliferation index did not significantly predict mortality (Ki-67 ≤ 10 vs. >10 %, 9.0 vs. 3.2 years, P = 0.0833), but resection margins did (R1 vs. R2, P = 0.0066; R0 vs. R2, P < 0.0001). The urinary steroid profile did not predict mortality (normal vs. pathologic urine profile: median survival 6.6 vs. 3.3 years, P = 0.261).ConclusionsThe prognosis was generally poor and macroscopically positive resection margins resulted in a worse prognosis. However, some patients were still alive many years following primary surgery with no sign of residual disease.

【 授权许可】

CC BY   
© Calissendorff et al. 2016